Evidence map›Paper›PMID 25936635›Full record

Trial reportCritical care (London, England)2015

Propranolol attenuates hemorrhage and accelerates wound healing in severely burned adults.

Arham Ali, David N Herndon, Ashish Mamachen, Samir Hasan, Clark R Andersen, Ro-Jon Grogans, Jordan L Brewer, Jong O Lee, Jamie Heffernan, Oscar E Suman and 1 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03452072 (Efficacy and Safety of 0.25% Timolol Gel in Healing Surgical Open Wounds), which is not on this map. Cited by 45 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 5 pooled it
7.6field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03452072 phase2 / phase3completednot on this mapstarted 2018, after this paper: background citation

Efficacy and Safety of 0.25% Timolol Gel in Healing Surgical Open Wounds: A Randomized Controlled Trial

TypeinterventionalSponsorBrigham and Women's HospitalRan2018 to 2021Enrolled87ConditionsWound of Skin, Wound Heal, Wound Open, Surgical WoundArms0.25% Timolol gel with paraffin gauze dressings, Vaseline dressing
3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 5 syntheses or guidelines pooled it, 81 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Trial
  8. Trial
  9. Propranolol kinetics in plasma from severely burned adults.Burns : journal of the International Society for Burn Injuries · 2017
    Trial
  10. Trial
  11. Oxandrolone Coadministration Does Not Alter Plasma Propranolol Concentrations in Severely Burned Pediatric Patients.Journal of burn care & research : official publication of the American Burn Association
    Trial
  12. Review
  13. Review
  14. Review
  15. Review
  16. Article
  17. Article
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Arham AliDepartment of Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA. arhali@utmb.edu.
David N HerndonDepartment of Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA. dherndon@utmb.edu.
Ashish MamachenSchool of Medicine, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA. asmamach@utmb.edu.
Samir HasanSchool of Medicine, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA. sshasan@utmb.edu.
Clark R AndersenShriners Hospitals for Children, 815 Market Street, Galveston, TX, 77550, USA. clanders@utmb.edu.
Ro-Jon GrogansDepartment of Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA. ragrogan@utmb.edu.
Jordan L BrewerSchool of Medicine, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA. jbrewer@utmb.edu.
Jong O LeeDepartment of Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA. jolee@utmb.edu.
Jamie HeffernanDepartment of Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA. jaheffer@utmb.edu.
Oscar E SumanDepartment of Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA. oesuman@utmb.edu.
Celeste C FinnertyDepartment of Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA. ccfinner@utmb.edu.
The University of Texas Medical Branch at Galveston · USShriners Hospitals for Children - Galveston · US

Funding

Project 9: The role of androgen/corticosteroid in fat, muscle and glucose metabolism of burn victimsP50GM060338 · NIGMS · UNIVERSITY OF TEXAS MEDICAL BR GALVESTON · PI SZABO, CSABA · 2000 to 2017
$24.2M
UTMB Clinical and Translational Science AwardUL1TR000071 · NCATS · UNIVERSITY OF TEXAS MED BR GALVESTON · PI BRASIER, ALLAN R. · 2012 to 2014
$14.4M
MODULATION OF THE POSTBURN HYPERMETABOLIC RESPONSER01GM056687 · NIGMS · UNIVERSITY OF TEXAS MEDICAL BR GALVESTON · PI HERNDON, DAVID N. · 1998 to 2017
$9.0M
Oxandrolone and Exercise: A potent therapy in the rehabilitation from burnsR01HD049471 · NICHD · UNIVERSITY OF TEXAS MED BR GALVESTON · PI SUMAN-VEJAS, OSCAR E. · 2006 to 2019
$5.8M
POSTDOCTORAL TRAINING IN TRAUMA &BURNST32GM008256 · NIGMS · UNIVERSITY OF TEXAS MEDICAL BR GALVESTON · PI Celeste Campbell Finnerty, Oscar E. Suman-Vejas · 1990 to 2026
$4.0M
Effects of Chronic Catecholamine Exposure on Post-burn ScarringR01GM112936 · NIGMS · UNIVERSITY OF TEXAS MED BR GALVESTON · PI FINNERTY, CELESTE CAMPBELL · 2015 to 2019
$1.8M
NCATS NIH HHS UL1 TR000071NCATS NIH HHS UL1TR000071NICHD NIH HHS R01 HD049471NICHD NIH HHS R01-HD049471NIGMS NIH HHS P50 GM060338NIGMS NIH HHS P50-GM060338NIGMS NIH HHS R01 GM056687NIGMS NIH HHS R01-GM056687NIGMS NIH HHS R01 GM112936NIGMS NIH HHS T32 GM008256NIGMS NIH HHS T32-GM008256PHS HHS R01-112936-01
6 · The paper itself

Abstract

introductionPropranolol, a nonselective β-blocker, exerts an indirect effect on the vasculature by leaving α-adrenergic receptors unopposed, resulting in peripheral vasoconstriction. We have previously shown that propranolol diminishes peripheral blood following burn injury by increasing vascular resistance. The purpose of this study was to investigate whether wound healing and perioperative hemodynamics are affected by propranolol administration in severely burned adults.

methodsSixty-nine adult patients with burns covering ≥ 30% of the total body surface area (TBSA) were enrolled in this IRB-approved study. Patients received standard burn care with (n = 35) or without (control, n = 34) propranolol. Propranolol was administered within 48 hours of burns and given throughout hospital discharge to decrease heart rate by approximately 20% from admission levels. Wound healing was determined by comparing the time between grafting procedures. Blood loss was determined by comparing pre- and postoperative hematocrit while factoring in operative graft area. Data were collected between first admission and first discharge.

resultsDemographics, burn size, and mortality were comparable in the control and propranolol groups. Patients in the propranolol group received an average propranolol dose of 3.3 ± 3.0 mg/kg/day. Daily average heart rate over the first 30 days was significantly lower in the propranolol group (P < 0.05). The average number of days between skin grafting procedures was also lower in propranolol patients (10 ± 5 days) than in control patients (17 ± 12 days; P = 0.02), indicative of a faster donor site healing time in the propranolol group. Packed red blood cell infusion was similar between groups (control 5.3 ± 5.4 units vs. propranolol 4.4 ± 3.1 units, P = 0.89). Propranolol was associated with a 5 to 7% improvement in perioperative hematocrit during grafting procedures of 4,000 to 16,000 cm(2) compared to control (P = 0.002).

conclusionsAdministration of propranolol during the acute hospitalization period diminishes blood loss during skin grafting procedures and markedly improves wound healing in severely burned adults. As burn patients require serial surgical interventions for motor and cosmetic repair, restricting blood loss during operative intervention is optimal.

Indexed as

Severity of Illness IndexAdrenergic beta-AntagonistsAdultBlood Loss, SurgicalBurnsCohort StudiesFemaleHumansMaleMiddle AgedPropranololSkin TransplantationWound HealingAdrenergic beta-AntagonistsPropranolol

Identifiers

PMID25936635
PMCPMC4432824
OpenAlexW2131404327

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.